Death On Call: Death Table of Contents DefinitionsPronouncing DeathEnd-of-Life Care Definitions DefinitionsCardiac Death: Irreversible Cessation of Cardiac ActivityMost CommonBrain Death: Irreversible Cessation of All Brain Functions, Including the Brainstem*See Brain Death – The Trauma ICULazarus Phenomenon/Lazarus SyndromeAutoresuscitation (Spontaneous Return of Circulation) After Failed CPR/Pronouncement of DeathPossible Causes:Release of Pressure, Previously Built-Up by CPR, Triggers Cardiac Electrical ActivityHyperkalemiaHigh-Doses of Epinephrine Pronouncing Death Pronouncing Cardiac DeathObserve for At Least 2 Minutes for Signs of LifeExamination:No Response to Tactile StimuliApneaAbsent Skin PerfusionAbsent Heart SoundsAbsent PulseRelationship to Cardiopulmonary Resuscitation (CPR)Pronouncement Should Be Decoupled from Cessation of CPRSimultaneous Declaration at the Time of CPR Cessation Can Be Associated with Autoresuscitation & Cause Trauma for Family & StaffPatients Should Be Observed for ≥ 10 Minutes After CPR Cessation Before Formal Pronouncement is MadeOnce Pronounced – Record Date & Time of DeathPronouncing Brain Death*See Brain Death – The Trauma ICU End-of-Life Care Delivering Bad News*See Delivering Bad NewsEnd-of-Life Care*See End-of-Life Care